Doctor Name: | JAMES PUGLIESE |
NPI Number: | 1063764884 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCMHC |
License Number: | 068.0081950 |
Business Practice Address: | 174 Elm St Montpelier, VT - 056022262 |
Business Phone Number: | 8024334438 |
Business Fax Number: | |
Mailing Address: | 174 Elm St, MONTPELIER |
State: | VT |
Postal Code: | 056022262 |
Phone Number: | 8024334438 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2012 |
NPI Last Update Date: | 10/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 068.0081950 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |